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Strategic options for syphilis control in Papua New Guineae impact and cost-effectiveness projections using the syphilis interventions towards elimination (SITE) model

引用

Infectious Disease Modelling 2021年第1期6卷 584-597页

作者： Shepherd Machekera Peniel Boas Poruan Temu Zimmbodilion Mosende Namarola Lote Angela Kelly-Hanku S.Guy Mahiane Robert Glaubius jane rowley Anup Gurung Eline Korenromp Government of Papua New Guinea National Department of HealthAOPI CenterWaigani DrivePO Box5896Port MoresbyPapua New Guinea World Vision International Ruta PlaceMorata StGordons.P.O Box 4254BorokoNational Capital DistrictPort MoresbyPapua New Guinea UNAIDS Papua New Guinea Country Office Port MoresbyPapua New Guinea WHO Papua New Guinea Country Office Communicable Disease&Health Emergency Dept.AOPI CentreWaigani DrivePort MoresbyPapua New Guinea Papua New Guinea Institute of Medical Research 441 Homate StreetPO Box 60GorokaEastern Highland ProvincePapua New Guinea Kirby Institute UNSW SydneyWallace Wurth BuildingHigh StreetUNSW Australia KensingtonNSW 2052SydneyAustralia Avenir Health ModellingPlanning and Policy Analysis Dept.655 Winding Brook DriveGlastonburyCT06033USA Independent Consultant 135 Gloucester TerraceW26DXLondonUK Avenir Health ModellingPlanning and Policy Analysis Dept.150 Route de FerneyPO box 2100CH-1211 Geneva 2Switzerland

Objectives:Papua New Guinea(PNG)has among the highest rates of sexually transmitted infections(STIs)globally and is committed to reducing their *** Syphilis Interventions Towards Elimination(SITE)model was used to explore the expected impact and cost of alternative syphilis intervention scale-up ***:SITE is a dynamical model of syphilis transmission among adults 15-49 *** are divided into nine groups based on sexual behaviour and into six stages of *** model was calibrated to PNG using data from routine surveillance,biobehavioural surveys,research studies and program *** included syphilis prevalence,risk behaviours,intervention coverage and service delivery unit *** compared different interventions(clinical treatment,contact tracing,syphilis screening,and condom promotion)for incidence and cost per infection averted over ***:Increasing treatment coverage of symptomatic primary/secondary-stage syphilis cases from 25-35%in 2020 to 60%from 2023 onwards reduced estimated incidence over 2021-2030 by 55%,compared to a scenario assuming constant coverage at 2019-2020 *** introduction of contact tracing in 2020,assuming 0.4 contacts per symptomatic person treated,reduced incidence over 2021-2030 by 10%.Increasing screening coverage by 20-30 percentage points from the 2019-2020 level reduced incidence over 2021-2030 by 3e16%depending on the target ***-up clinical,symptom-driven treatment and contact tracing had the lowest cost per infection averted,followed by condom promotion and periodic screening of female sex workers and men who have sex with ***:PNG could considerably reduce its syphilis burden by scaling-up clinical treatment and contact tracing alongside targeted behavioural risk reduction *** is a useful tool countries can apply to inform national STI programming and resource allocation.

关键词： Syphilis Prevention Treatment Cost-effectiveness Resource allocation National program strategy

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